CAJ | 학술논문

目的研究131I对Graves病患者甲状腺细胞凋亡的影响.方法将47例Graves病患者按随机数字表法分组:治疗后2周组与4周组,均行131I治疗,采用配对t检验检测131I治疗前后甲状腺细胞促凋亡蛋白(Fas、FasL)及抗凋亡蛋白(Bcl-2)的变化,并采用t检验比较2组间的差别;采用直线相关分析法分析单位131I治疗剂量与凋亡蛋白的相关性及131I治疗后3个月患者sTSH与凋亡蛋白的相关性.结果 2组患者治疗后较治疗前Fas、FasL及Bcl-2表达[以阳性单位(PU)表示]明显增加,2周组分别为22.84±9.31与16.20±6.75,21.13±6.29与14.56±4.06,21.69±7.83与15.22±5.94,t值分别为-3.08、-3.73、-4.05,P均<0.05;4周组分别为21.69±4.52与15.83±5.03,19.11±3.75与14.02±4.98,19.06±3.44与16.63±4.73,t值分别为-5.26、-5.00、-2.41,P均<0.05.2周组与4周组相比:Fas、FasL及Bcl-2的差异均无统计学意义(t=0.53,0.82,1.46,P>0.05),4周组标准差小,即变异度小.2组中单位131I治疗剂量与Fas、FasL相关性较好,而与Bcl-2无相关性:2周组rFas=0.631,rFasL=0.784(P均<0.05),rBcl-2=-0.094(P>0.05);4周组rFas=0.727,rFasL=0.763(P均<0.05),rBcl-2=0.102(P>0.05).131I治疗后3个月患者sTSH与凋亡蛋白相关性较好,rFas=0.433,rFasL=0.601,rBcl-2=-0.397(P均<0.05).结论 131I可同时诱导Graves病患者甲状腺滤泡上皮细胞表达促凋亡蛋白Fas、FasL和抗凋亡蛋白Bcl-2,其中以促凋亡作用为主.
목적 연구131I대Graves병환자갑상선세포조망적영향.방법 장47례Graves병환자안수궤수자표법분조:치료후2주조여4주조,균행131I치료,채용배대t검험검측131I치료전후갑상선세포촉조망단백(Fas、FasL)급항조망단백(Bcl-2)적변화,병채용t검험비교2조간적차별;채용직선상관분석법분석단위131I치료제량여조망단백적상관성급131I치료후3개월환자sTSH여조망단백적상관성.결과 2조환자치료후교치료전Fas、FasL급Bcl-2표체[이양성단위(PU)표시]명현증가,2주조분별위22.84±9.31여16.20±6.75,21.13±6.29여14.56±4.06,21.69±7.83여15.22±5.94,t치분별위-3.08、-3.73、-4.05,P균<0.05;4주조분별위21.69±4.52여15.83±5.03,19.11±3.75여14.02±4.98,19.06±3.44여16.63±4.73,t치분별위-5.26、-5.00、-2.41,P균<0.05.2주조여4주조상비:Fas、FasL급Bcl-2적차이균무통계학의의(t=0.53,0.82,1.46,P>0.05),4주조표준차소,즉변이도소.2조중단위131I치료제량여Fas、FasL상관성교호,이여Bcl-2무상관성:2주조rFas=0.631,rFasL=0.784(P균<0.05),rBcl-2=-0.094(P>0.05);4주조rFas=0.727,rFasL=0.763(P균<0.05),rBcl-2=0.102(P>0.05).131I치료후3개월환자sTSH여조망단백상관성교호,rFas=0.433,rFasL=0.601,rBcl-2=-0.397(P균<0.05).결론 131I가동시유도Graves병환자갑상선려포상피세포표체촉조망단백Fas、FasL화항조망단백Bcl-2,기중이촉조망작용위주.
Objective To investigate the effect of 131I on apoptosis of thyrocytes in patients with Graves disease. Methods Forty-seven patients with Graves disease were divided into two groups, two week group (G2w) and four week group (G4w). All patients underwent thyoid needle biopsy before 131I treatment and the repeated biopsy at two weeks (G2w) or four weeks (G4w) after 131I treatment. The positive units of pro-apoptotic proteins (Fas, FasL) and anti-apoptotic protein (Bcl-2) were studied with immunohistochemistry staining. The differences of the two groups were compared with t-test. Liner correlation analysis was applied to study the correlation between 131I dose and apoptosis-related proteins and that between serum sTSH after 131I treatment and apoptosis-related proteins. Results Fas, FasL and Bcl-2 expression (positive units) were significantly increased in both groups after 131I treatment, G2w :22.84 ± 9.31 vs 16.20 ± 6.75,21.13±6.29vs 14.56±4.06, 21.69±7.83 vs 15.22 ±5.94, t= -3.08, -3.73, -4.05 (allP<0.05); G4w:21.69 ±4.52 vs 15.83 ±5.03, 19. 11 ±3.75 vs 14.02 ±4.98, 19.06 ±3.44 vs 16.63 ±4. 73, t = - 5.26, - 5.00, - 2.41 (all P<0.05). However, no statistical differences were found between G2w and G4w (t = 0. 53, 0. 82, 1.46, all P > 0.05). Significant correlation was found between 131I 0. 727, rFasL = 0. 763 (both P<0.05)), but not between the dose and Bcl-2, rBcl-2 = - 0. 094, 0. 102(both P > 0.05). There were significant correlation between serum sTSH three months after 131I treatment and apoptosis-related proteins, rFas = 0.433, rFasL = 0. 601, rBcln2 = - 0. 397, (all P<0. 05). Conclusions 131I can induce thyrocytes to express the pro-apoptotic proteins in patients with Graves disease.